NPIMap

Organization Active NPI

Wisconsin Dental Group, S.C.

Doing business as ForwardDental Madison West

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1962532325
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WISCONSIN DENTAL GROUP, S.C.
Doing business as
ForwardDental Madison West
Practice address
2 Science CT Ste 100
Madison, WI 53711-1090
Phone
(262) 542-8860
Fax
(262) 524-9225
NPI assigned
Mar 6, 2007
Organization subpart
Yes
Parent organization
WISCONSIN DENTAL GROUP, S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2 Science CT Ste 100
Madison, WI 53711-1090

Mailing address

2 Science CT Ste 100
Madison, WI 53711-1090
Phone (262) 542-8860

Other names 1

  • ForwardDental Madison West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wi DTL GRP-HLS CRNS32 organizations share this tax ID, including this one
Part of
Wi DTL GRP-HLS CRNS

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

2 Science Ct
Ste 100
Madison, WI 53711
Phone (262) 542-8860

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1962532325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SCIENCE CT STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111090",
            "telephone_number": "262-542-8860",
            "fax_number": "262-524-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SCIENCE CT STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111090",
            "telephone_number": "262-542-8860",
            "fax_number": "262-524-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN DENTAL GROUP, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WISCONSIN DENTAL GROUP, S.C.",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ForwardDental Madison West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.